EYE CANCER – WHAT CAUSES MELANOMA OF THE EYE

In the UK alone, there are approximately 750 cases of eye cancer (ocular cancer) diagnosed each year.

Cancer that develops within your eye:

• Eye melanoma (or ocular melanoma/uveal melanoma)
• Squamous cell carcinoma
• Lymphoma
• Retinoblastoma – a childhood cancer

The tissues surrounding your eyeball, is where the cancer can sometime develop. Also, it can spread from other parts of your body, including the lungs or breasts to the eyes.

Within this topic, the melanoma of the eye will be discussed which is one of the more common types of eye cancer. However, here is some further information on 6 rare eye conditions that you may want to know about.

Symptoms of eye cancer

Eye cancer is something that doesn’t exactly have obvious symptoms and may be found in a routine eye test.

The symptoms of eye cancer can include:

• Blurred vision
• Shadows, flashes of light, or wiggly lines in your vision
• A dark patch in your eye that’s getting bigger
• Bulging of 1 eye
• Partial or loss of vision
• A lump on your eyelid or in your eye that’s increasing in size
• Pain in or around your eye, although this is rare

The above symptoms can also be caused by minor eye conditions. So, they are not necessarily a sign of cancer.

However, it is best to be safe and see a doctor as soon as possible. Also, we would all like to keep our eyesight working at its best capabilities and here at SpaMedica we want to try and help avoid anything happening to your eyes. NHS have some great insightful information on how to keep them safe!

Melanoma of the eye

Melanocytes, a pigment producing cells is what causes the melanoma cancer to develop. Generally, melanomas are found in the skin, but it is possible for it to happen on other parts of the body, such as the eye.

The eyeball is the most common place that is affected by eye melanoma. It is also known as uveal or choroidal melanoma, depending on which part of your eye is directly affected.

It is also able to influence the thin layer that covers the front of the eye (conjunctiva) or the eye lid.

What causes eye melanoma?

When the pigment producing cells in the eyes divide and multiply at an unusually rapid pace, it produces a lump of tissue which is known as a tumour. This is how eye melanoma is caused.

Why does this happen? We do not have a clear idea yet however, some of the risk factors that may increase this happening are:

• White or pale skin – it mostly influences people with fairer skin.
• Use of sun beds – exposure to the UV radiation of sunbeds can increase the risk of eye melanoma.
• Lighter eye colour – in comparison to people with brown eyes, if you have green, blue or grey eyes, there is a higher chance of you developing eye melanoma.
• Overexposure to sunlight – this increases the risk of skin cancer however; it also increases the risk of eye melanoma too. Also, here are some insightful tips if you would like to protect your eyes from being damaged by the sun and potentially avoiding a cataract.

With coming of age, eye melanoma tends to be diagnosed in people over the age of 50.

Diagnosing melanoma of the eye

If you have a very serious problem with your eyes, your GP or optician will refer you to a specialist eye doctor for an assessment. They are called ophthalmologist.

There are 4 centres In the UK that can treat you for eye melanoma, located in London, Sheffield, Liverpool and Glasgow.

There is a chance you will have several different tests at the centre which will consist of:

• An eye examination – to look further in detail of your eye and check for any irregularities.
• Ultrasound scan of your eye – the doctor will need to find the positioning of the tumour and its size. A small probe is placed above the closed eye whilst a high frequency sound waves are used in order to create an image of the inside of your eye.
• A fluorescein angiogram – Images of the potential cancer are taken using a unique camera. The after dye is injected into your blood stream in order to highlight the tumour.

On a rare occasion, a thin needle may be used in order to take away a small sample of cells from the tumour.

The reason they will need to do this, is to identify any clear analysis of the cancer spreading or coming back.

Treatments for eye melanoma

The size and location of the tumour will determine the treatment required for melanoma.

The benefits and possible complications will be explained to you by your care team.

For eye melanoma, the main treatments are the following:

• Brachytherapy – in order to completely terminate the cancerous cells, small plates inserted with radioactive material called plaques are put close to the tumour and left there for approximately a week.
• External radiotherapy – for the machine to completely kill the cancerous cells within the tumour, beams of radiation are carefully aimed at it.
• Surgery for removal of the eye – for this procedure to take place, the tumour needs to be small enough as well as having some of your vision.  
• Removal of the eye (enucleation) – this treatment may prove to be compulsory if the tumour is large or you have lost your vision. Eventually, an artificial eye will be used in order to replace your eye to match the other eye.

Eye melanoma – overview

• Approximately 8 out of 10 people (80%) diagnosed with a small eye melanoma will for at least 5 years after it has been diagnosed.
• Approximately 7 out of 10 people (70%) diagnosed with a medium eye melanoma will for at least 5 years after it has been diagnosed.
• Approximately 5 out of 10 people (50%) diagnosed with a large eye melanoma will for at least 5 years after it has been diagnosed.

What is the Ciliary body?

The ciliary body is a circular structure that is found just behind the iris. It is made up of the ciliary muscle and it is part of the eye that produces a fluid called aqueous humour. Essentially, what this does is that the shape of the lens changes when your eye is focused on an object that is near by.

Part of the uvea, the cirliary body also includes the iris (the circular, coloured curtain of the eye that surrounds the pupil) as well as the choroid of the eye, which is the thin layer of the eye found within the sclera (the white area of the eye) and the retina (it detects light, and generates impulses that travel through the optic nerve to the brain).